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WE MAKE GOOD THINGS HAPPEN

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My mission is to help people live healthier and financially secure lives. I specialize in medicare and medical Insurance solutions, serving the Tampa Bay Area.

Name
Email
Date of Birth
Part A Effective Date*
Part B Effective Date*
Phone Number
Monthly Income
Do you use tobacco products? YesNo
When was the last time you used tobacco products?
Address
Comment

*DISCLAIMER: A sales agent may mail, call or email as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.